This project consists of 48 subprojects, each of which comprises a separate question to be asked of our comprehensive computerized clinical data storage and retrieval systems. We have collected data on more than 4,400 kidney transplants performed at the University of Minnesota since 1968; all information is stored in the mainframe computer system. We have developed an extensive microcomputer database. To date, over 2,300 patients have been entered (all patients transplanted since 1984). Multiple details (preoperative risk factors; tissue typing; the transplant admission and surgery; donor information; posttransplant readmissions, rejections, biopsies, infections, and other complications; quality of life; rehabilitation) are available. New transplants are entered progressively; in addition, we are adding patients transplanted prior to 1984 into this database. Two types of studies are planned-retrospective and prospective. In some of these subprojects, data collection has been completed and analysis is planned. In others, long-term follow up is required. Our microcomputer computer database permits use to study transplant risk factors to an extent that has not previously been possible. The computer allows analysis of mini-series of subgroups of patients and/or multivariate analysis of the importance of risk factors. Among the most important of the subprojects are: D) Complications in renal allograft recipients and kidney-pancreas recipients; F) Pediatric education achievement J) The impact of "renal mass" on outcome; L) Continuing study of how to best present posttransplant data analyses; M) Differential outcome of kidney transplant recipients with biopsy- proven chronic rejection; T) Relationship of primary disease to prognosis; U) Natural history of CMV disease treated with ganciclovir; AA) Quality of life after kidney transplantation FF) Risk factors for recurrent renal allograft rejection